Is Provision of Healthcare Sufficient to Ensure Better Access? An Exploration of the Scope for Public-Private Partnership in India

摘要

Background: India’s economic growth rate in recent years has been fairly impressive. But, it has been consistently udfailing to make considerable progress in achieving health related Millennium Development Goal (MDG) targets. Lack udof coherence between provisions and utilization becomes the face of the problem. Inadequacies in outreach, access udand affordability coupled with escalating healthcare costs have aggravated the problem. Here the application of PublicPrivate Partnership (PPP) model seems to have enormous potential to ease the impasse.udMethods:This paper tries to find the gap between the provisions and access in healthcare. The paper attempts udto construct a Health Infrastructure Index (HII) and Health Attainment Index (HAI) for different states of India. udConsidering the presence of regional variations found in health infrastructure and attainment among the states, two udstates, viz. Maharashtra (MAH) and West Bengal (WB) have been chosen. Then contributions of health programs like udRashtriya Swasthya Bima Yojana (RSBY), National Rural Telemedicine Network (NRTN) and Fair Price Shops (FPS), udall PPP initiatives, have been assessed for both the states by carrying out comprehensive benefit-cost analysis.udResults:The health infrastructure for population per unit area captures the outreach/delivery issue and the health udattainment reveals the true scenario about how far the infrastructure has been accessed by the people; and the gap udbetween the two, as the paper finds, is the root of the problem. The combined effect of RSBY and NRTN will leave both udMAH and WB higher benefits in terms of health attainment. The contributions of RSBY and NRTN have been assessed udfor both the states by carrying out comprehensive benefit-cost analysis. FPS comes up with immense benefits for WB. udIt is yet to be implemented in MAH. udConclusion:The outreach and access problems arising from deficiencies in infrastructure, human resources and udfinancial ability are expected to be well-addressed by the spread of RSBY and NRTN jointly. The FPS mechanism under udPPP initiative can be an effective tool in solving affordability problem by reducing the cost of treatment.